Individual
DR. NICAS YIANNIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5943 CENTRAL AVE, PORTAGE, IN 46368-2946
(219) 762-9567
(219) 762-8842
Mailing address
5943 CENTRAL AVE, PORTAGE, IN 46368-2946
(312) 375-8330
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019-025967
IL
1223G0001X
General Practice Dentistry
Primary
12011372A
IN
Other
Enumeration date
06/01/2007
Last updated
10/25/2012
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